Tag Archives: soccer

Paul Dhillon is a Clinical Assistant Professor in Academic Family Medicine at the University of Saskatchewan

Twenty-two physicians from across Canada recently left their examination rooms and operating theaters behind for a unique opportunity to represent Canada internationally at the World Medical Football Championships in Barcelona, Spain.

The championships have been occurring annually for 22 years with an associated medical sports and health symposium offered concurrently. This was Canada’s first ever team to participate. Canada was represented from coast to coast with physicians from Halifax to Vancouver selected for the team (see a full list of players below).

We began the tournament in a difficult group that contained the eventual runners-up, Sweden, and the 4th place finishers Australia ...continue reading →

Why are the Jamaicans so dominant in world sprinting? And, it’s not just Jamaicans, but those of Jamaican origin representing other countries such as Canada and the UK. Is there a genetic component? Yannis Pitsiladis, a world expert with access to the world’s largest biobank, found no unique genetic trait. Jamaicans’ believe that this dominance is from the eugenic effects of the slave trade - only the fittest and strongest survived ...continue reading →

As Brazil prepared for the FIFA World Cup, its people were conflicted between football and needs of the country. We have always called ourselves the Soccer’s Country (although we did not invent it, do not have the wealthiest national championship and, as is now clear, do not have the best team), Brazil is currently struggling to develop in other important areas as we strive to improve public services, whether in education, safety and health. In recent years its people have gone on the streets to call for the end of the military government and for direct elections. We fought for a Universal Health System and have tried to implement it for the past 30 years.

“Every Brazilian is a soccer coach” we say. Soccer is the topic of conversation in in every bar, and every media outlet, newspaper and blog is full of analysis of the game, its system and tactics. Everyone can name the iconic past soccer players or coaches, with Pele, Garrincha, Ademir da Ghia, and we had Tele Santana and Zagallo, with, more recently, Ronaldo, Rivaldo, and Ronaldinho Gaúcho.

But in the past two years, people have been concerned with other issues. Massive popular demonstrations ask how public money is spent and question tax exemptions in our essentially poor and uneven country. For primary care physicians, it is clear that, while everyone has the answers for our soccer team, we do not have solutions in other areas, notably in the Health System. We lack examples of past successful public health initiatives almost as much as we have a wealth of past players and coaches. Unfortunately, we seem unable to look outside our borders and learn from others. Maybe we think that because foreigners have learned from our soccer, and how it has adapted and evolved, we can create our own Health System from scratch, ignoring or blind to the trends worldwide.

The voices on the streets argue that, instead of, or in addition to, our “FIFA pattern” stadiums, we should have… more hospitals! “FIFA pattern” hospitals! At the same time, primary care is limited with little access, poor continuity and almost no coordination of care, and with just 1,5% of physicians specialized for general primary care (community family physicians). People simply don’t know that, rather than more hospitals, we need more quality primary care, offering timely and comprehensive care as is delivered in the more organized services of Europe or Canada.

While Neymar goes to the “top notch” hospital, to receive “top notch” diagnostic imaging technology, my next patient tells me that his chronic lumbar pain is not, after all, related to his obesity and sedentarism as I had told him, but the result of an injury “just like Neymar’s” that he had years ago, and he asks for a CT and/or MRI. As I prepare myself to discuss the correct management, defending my patient from harmful health propaganda, I just wonder when we will have our McWhinney to inspire the physicians and patients to a better understanding of what we need - just as Pelé always reminds us how the game should be played!

Its not just the football. Sports docs watch the World Cup medical stories with great interest—which players are injured, what happened and how they are managed. Luis Suárez, suddenly infamous, scored two goals, effectively eliminating England, just weeks after an arthroscopy. And, with the current controversy over concussion and possible long term chronic traumatic encephalopathy, we are especially aware of head injuries. In 2010, team doctors of the 32 finalist teams reported 125 injuries in 64 matches with 104 injuries during training. Most of these injuries were not serious and the incidence of match injuries was lower than in the three preceding World Cups. So far, this year looks even better. The World Cup only offers a short window on acute soccer injuries, however, and it may be more important to look at the long term sequelae and, in particular, if soccer might lead to long term osteoarthritis. There is some evidence that it does but we await the findings of what may be the definitive study, Osteoarthritis Risk of Professional Footballers, undertaken by the Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis—a major UK and international collaboration. The World Cup is also likely to generate other tangential papers such as to how it might influence the number of ER admissions or myocardial infarctions.

Exercise in treating arthritis initially seemed counter intuitive. Rob Petrella, now at University of Western Ontario, first brought this to my attention in a poster at a medical conference, and it led to his systematic review in 2000 asking if exercise was an effective treatment for osteoarthritis of the knee. At that time there were few sufficiently powered randomised controlled trials but, overall, the evidence seemed in favour. Last year, a similar systematic review showed overwhelming evidence in favour of exercise for lower limb osteoarthritis. This was a sequential meta analysis and, what was particularly important, was that there was sufficient evidence to show physical activity was beneficial as early as 2002. It can take a long time to change our minds and integrate evidence into practice.

Evidence in treating arthritis is not always what one might expect. Just a few weeks ago, Kim Bennell and her colleagues published a high quality randomized controlled trial on the effect of physical therapy in hip osteoarthritis. Patients had 10 treatments over 12 weeks comprising education and advice, manual therapy, home exercise, and gait aid if appropriate. There was, perhaps unexpectedly, no difference in pain or function compared with sham treatment. I cannot imagine that the findings of this study were welcomed by Kim’s physiotherapy colleagues. Its not just in football where the results can be surprising, unexpected and disappointing for the supporters.